Individual
MR. ADEM MARTIN GERAGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NPP
Contact information
Practice address
4904 19TH AVE, ASTORIA, NY 11105-1002
(347) 774-8000
Mailing address
4904 19TH AVE, ASTORIA, NY 11105-1002
(347) 774-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
596486
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401769
NY
Other
Enumeration date
08/28/2014
Last updated
08/28/2014
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